Secret supervised drug injection facility has been operating at US site for years

Lives have been saved at site run by a social service agency in an undisclosed city, according to newly released data, in an effort to battle the overdose epidemic

For nearly three years, in an undisclosed US city, a social service agency has quietly been inviting people to inject illegal drugs at a clandestine site, without the governments approval.

More than 100 people have injected drugs at the site, according to data released Tuesday about the 2,754 injections. This data provides the first glimpse of what it would look like if the US decided to follow 10 other countries and open supervised injection facilities.

Researchers said two peoples lives were saved because they overdosed at the site, where staff had immediate access to the opioid reversal drug naloxone, and 90% of people who used there said they would have injected in a public restroom, street, park or parking lot if the site had not been available.

The secret site is modeled after legal facilities in countries including Canada, Denmark and France, where users can take drugs in a safe space with clean supplies. These facilities have been found to provide safety for users as well as communities where used needles can litter the streets, parks and public restrooms.

Kral and Peter Davidson, a medical sociologist at the University of California, provided a rare glimpse into the US facility in an American Journal of Preventative Medicine commentary published Tuesday. For two years, the facility has given an anonymous survey to its clients, who are overwhelmingly male (91.3%), white (80%) and homeless (80.5%).

There are limits to what the facility can offer, and what the data can reveal, because the site is not sanctioned, but the survey responses showed that in the previous 30 days, 25% of the users had witnessed an overdose outside the site and 67.45% had disposed of a syringe in a public place.

Supervised injection sites have long been controversial, but the scale of the opioid addiction crisis in the US which sees 91 people die from overdoses each day appears to be shifting attitudes.

But in 2014, these facilities were still far from becoming a reality in the US so the underground injection site was created. The staff didnt want to wait around for it to be sanctioned, Kral said.

The secret site has two rooms, one with five injection stations and the other for post-injection monitoring. It is open four to six hours per day, five days a week and is available by invitation only.

Users spend between 10 and 20 minutes in the room, which is always staffed by at least one person who has been trained in overdose prevention, resuscitation, using the opioid reversal drug naloxone and injection technique.

The sites existence, an act of public health civil disobedience, is a throwback to unsanctioned needle-exchange sites that appeared during the HIV/Aids crisis. In Canada, where supervised injection sites exist, activists have also created pop-up injection tents to respond to the opioid crisis.

Kral said he did not know about any other unsanctioned facilities in the US.

Soon, however, legal facilities could open in Seattle and San Francisco. There are also efforts underway to bring these facilities to other US cities, if lawmakers deem them safe and effective.

New York City approved $100,000 to study how an injection facility would impact the city; Seattle voted to open a site and San Francisco launched a task force to study the spaces after research found the city could save $3.5m annually with one 13-booth supervised injection facility. A similar study published in May found Baltimore could save $6m in medical costs if it built one supervised injection facility.

Kral said the unsanctioned facilitys data could help make the case for these sites: This has been open for almost for three years and the sky has not fallen.